We need to address variation between training schemes

In my last year of medical school, the Dean gave a lecture about the process of applying for Foundation Training. One comment that stuck with me was that all foundation posts are essentially the same.

I was delighted to get my first-choice rotation, but found I was handicapped by moving away to a different region. I had some character building rotations and quickly got used to hearing from better informed trainees: ‘Oh you have that job. Yeah, I put that towards the bottom of my list.’

So, the reason that comment has stuck is that I now know it to be a lie. (Not that I’m bitter, but I’ve put it in the same league as finding out from your parents that Father Christmas isn’t real. Or, that first chemistry lesson in college when you’re told by the science teacher you respect that electron shells were a fib; 2-8-8… is out and orbitals are the new gospel.)

Variation in training programmes, including general practice, is very real. When I moved region again after Foundation Training, I learned from my previous mistake and did my research. I spoke with people in the training programme in the region I was applying to. It was well worth the effort and is something I have advised every single junior doctor I have worked with to do. I’ve had great rotations since, based on the guidance I received from others.

What’s interesting is that variation exists not just between different regions, but also within regions. Last week I had a chat with another trainee in a neighbouring VTS at an AKT preparation course. We realised that our VTS administrators had different interpretations of the rules regarding study leave to prepare for the exam.

We’re lucky to be in a region with a trainees’ committee, which meets up every couple of months to discuss training issues and talk with our head of school. This will be something I’ll feed back to one of the reps to bring up in their next meeting.

My Dean of medical school also stated that where you work is the most important thing we choose in terms of our wellbeing – they were right. But it’s not just the physical location of the town or city – which is what they meant – but the educational set-up too.

It may be that trainees accept these disparities if it allows them to live near friends and family. But that shouldn’t mean these disparities are appropriate or forgivable. This is a theme I will come back to as it’s one of the biggest sources of my personal frustration with medical training.